title: Spatiotemporal patterns of Japanese encephalitis in China, 2002-2010.
abstract: OBJECTIVE
  The aim of the study is to examine the spatiotemporal pattern of Japanese Encephalitis (JE) in mainland China during 2002-2010. Specific objectives of the study were to quantify the temporal variation in incidence of JE cases, to determine if clustering of JE cases exists, to detect high risk spatiotemporal clusters of JE cases and to provide evidence-based preventive suggestions to relevant stakeholders.
  
  
  METHODS
  Monthly JE cases at the county level in mainland China during 2002-2010 were obtained from the China Information System for Diseases Control and Prevention (CISDCP). For the purpose of the analysis, JE case counts for nine years were aggregated into four temporal periods (2002; 2003-2005; 2006; and 2007-2010). Local Indicators of Spatial Association and spatial scan statistics were performed to detect and evaluate local high risk space-time clusters.
  
  
  RESULTS
  JE incidence showed a decreasing trend from 2002 to 2005 but peaked in 2006, then fluctuated over the study period. Spatial cluster analysis detected high value clusters, mainly located in Southwestern China. Similarly, we identified a primary spatiotemporal cluster of JE in Southwestern China between July and August, with the geographical range of JE transmission increasing over the past years.
  
  
  CONCLUSIONS
  JE in China is geographically clustered and its spatial extent dynamically changed during the last nine years in mainland China. This indicates that risk factors for JE infection are likely to be spatially heterogeneous. The results may assist national and local health authorities in the development/refinement of a better preventive strategy and increase the effectiveness of public health interventions against JE transmission.
authors.affiliation: Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, People's Republic of China.
authors.forename: Li-Ya
authors.initials: LY
authors.lastname: Wang
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Zhang
authors.forename: Fan
authors.initials: F
authors.lastname: Ding
authors.forename: Wen-Biao
authors.initials: WB
authors.lastname: Hu
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Soares Magalhaes
authors.forename: Hai-Long
authors.initials: HL
authors.lastname: Sun
authors.forename: Yi-Xing
authors.initials: YX
authors.lastname: Li
authors.forename: Wen
authors.initials: W
authors.lastname: Zou
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Qi-Yong
authors.initials: QY
authors.lastname: Liu
authors.forename: Shen-Long
authors.initials: SL
authors.lastname: Li
authors.forename: Wen-Wu
authors.initials: WW
authors.lastname: Yin
authors.forename: Liu-Yu
authors.initials: LY
authors.lastname: Huang
authors.forename: Archie C A
authors.initials: AC
authors.lastname: Clements
authors.forename: Peng
authors.initials: P
authors.lastname: Bi
authors.forename: Cheng-Yi
authors.initials: CY
authors.lastname: Li
mesh_terms: D002681:China / Q000453:epidemiology; D016000:Cluster Analysis; D004672:Encephalitis, Japanese / Q000453:epidemiology*; D006801:Humans; D013997:Time Factors; D019371:Topography, Medical